Start with Anti-TNF in RA? Not So Fast
The suggestion to hit rheumatoid arthritis (RA) early and hard with biologic therapies itself took a hit in a new study.
News
Limited Advantage to Very Early vs. Delayed Etanercept in RA
The VEDERA study sought to confirm whether the very early introduction of first-line etanercept+methotrexate (ETN+MTX) was superior to treat-to-target MTX (MTX-TT) in patients with early RA.
EULAR Recommendations on Sjögren’s Syndrome
The European League Against Rheumatism (EULAR) has established an international collaborative group (EULAR SS Task Force) to develop the first EULAR evidence and consensus-based recommendations for the management of patients with Sjogens syndrome (SjS).
Half of Opioids Rx Come from 1% of MDs
The BMJ reports that while most US providers are cautious in their prescribing, half of opioid prescriptions are written by 1% of providers.
Between 2003 and 2017, there was an annual average of 669495 providers prescribing 8.9 million opioid prescriptions.
RheumNow Podcast- 2019 EULAR RA Guidelines (1.31.20)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
Hormone Therapy for Postmenopausal Women
The NEJM weighs in on the problem of post-menopausal osteoporosis (OP) and tackles the use of hormonal therapy. The decline in estrogen after menopause may increase risks for osteoporosis, cardiovascular disease, and cognitive decline. The use of hormone replacement therapy (HRT) to obviate these issues may be primarily driven by hot flashes in postmenopausal women.1 Who may benefit from hormone therapy among postmenopausal women?
Knee Replacements Last 25 Years
UK registry reports that greater than 80% of total knee replacements can last for 25 years.
The outcomes regarding the duration and durability of knee arthroplasties is sketchy, with many orthopedists projecting a 15 to 20 year survivial. Hence the need for an appraisal of the data.
Rheumatoid Arthritis Antibodies Linked With COPD
Women who were seropositive for anti-citrullinated protein antibodies (ACPA) and ultimately went on to develop rheumatoid arthritis (RA) were also at increased risk for being diagnosed with chronic obstructive pulmonary disease (COPD), analysis of data from the Nurses' Health Study showed.
Book Review: “Great Health Care Value: Chronic Diseases, Practice Teams and Population Management”
The US healthcare market has evolved into an incredibly expensive system that often does not deliver good medical outcomes. While most of us know these problems exist, we rarely have up-to-date data or can offer alternatives to the way we manage care, especially to the chronically ill who consume much of our health care dollars. In their book, authors Tim Harrington, MD and Andrew Johnson, MS, MBA offer insights, evidence and experience on how we may do our part to improve the management of chronic rheumatic/orthopedic issues.
NSAIDs May Impair Healing if Taken Nightly
A new study in Scientific Reports suggest that circadian rhythms play an important role in wound healing, and that nonsteroidal anti-inflammatory drugs (NSAIDs) may be disruptive if taken at night given primary healing that occurs in a body at night.
2019 EULAR Recommendations for the Management of Rheumatoid Arthritis
The 2019 update to the EULAR recommendations on the use of synthetic and biological disease-modifying antirheumatic drugs in rheumatoid arthritis (RA) have been published in Annals of Rheumatic Disease - highlighting the efforts of an international consensus committee effort. In the end, the task force put forth 5 overarching principles and 12 recommendations concerning use of conventional synthetic DMARDs, glucocorticoids, biological DMARDs, biosimilar DMARDs, and targeted synthetic DMARDs (the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib).
RheumNow Podcast- A Good First Impression (1.24.20)
Dr Jack Cush comments on this week's journal articles, reviews and studies.
QD Clinic - "Doc, When Can I Stop?"
QD Clinic - Lessons from the clinic. In this video: Patients stable on a biologic need guidance on when, and if, they can stop their biologic.
Low Risk of Inflammatory Arthritis in Hidradenitis Suppurativa Patients
JAMA Dermatology reports that after the onset and diagnosis of hidradenitis suppurativa (HS), such patients have a higher risk of certain forms inflammatory arthritis.
